Wang Xishun, Zhang Yadong, Hou Shuxun, Wu Wenwen, Zhang Hong, Luo Dianzhong, Gu Dongqiang, Zhao Yantao
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Jan;28(1):21-5.
To investigate the effects of meniscectomy and transplantation repair ot the knee on the stress area and average pressure of the tibiofemoral articular surface so as to provide a reference for the relevant basic and clinical researches.
Seven qualified right knee joints from adult men cadavers were selected. Required structure was retained after careful dissection. The pressure-sensitive paper was clipped to the proper size in accordance with the measured size of the tibial platform to reserve. The experiment was divided into 4 groups: normal knee group (group A), knee meniscus injury group (group B), knee meniscectomy group (group C), and knee meniscus transplantation group (group D). A horizontal incision above the meniscus was made in the position of knee joint capsule, and the pressure-sensitive paper was placed into the medial and lateral space of the knee joint, then the proximal tibia and distal femur were fixed stably and finally a universal mechanical machine was used for testing in appropriate environmental conditions (the knee joints were given longitudinal 700 N pressure at 00 extension and 30, 60, 90, and 1200 flexion for continuous 120 seconds) until the full color reaction. The knee models were prepared, and then the universal mechanical machine was used to perform a test according to the method stated above respectively. The pressure-sensitive paper was removed, and the color negative films were separated and marked. Colorful image analysis system was used to calculate and analyze the stress area and average pressure after the scanner being used to collect image information.
The stress area was gradually reduced and the average pressure was gradually increased with increasing flexion angle of the knee. There was significant difference in the stress area and the average pressure between various flexion angles in 4 groups (P < 0.05). Group C had significantly lower stress area and significantly higher average pressure than the other 3 groups (P < 0.05), but no significant difference was found among groups A, B, and D (P > 0.05).
The stress of the tibiofemoral articular surface significantly increases after knee meniscus injury or resection, and the average pressure significantly increases. The stress of the tibiofemoral articular surface can be restored to almost normal after meniscus transplantation. Therefore, the injured meniscus should also be retained or repaired in the static state.
探讨膝关节半月板切除与移植修复对胫股关节面应力面积及平均压力的影响，为相关基础与临床研究提供参考。
选取7具成年男性尸体的右侧合格膝关节。仔细解剖后保留所需结构。根据测量的胫骨平台大小将压敏纸裁剪成合适尺寸备用。实验分为4组：正常膝关节组（A组）、膝关节半月板损伤组（B组）、膝关节半月板切除组（C组）和膝关节半月板移植组（D组）。在膝关节囊位置半月板上方做水平切口，将压敏纸放入膝关节内外侧间隙，然后将胫骨近端和股骨远端稳定固定，最后在适当环境条件下用万能机械试验机进行测试（膝关节在伸直0°及屈曲30°、60°、90°和120°时施加纵向700 N压力，持续120秒）直至出现全色反应。制备膝关节模型，然后分别按照上述方法用万能机械试验机进行测试。取出压敏纸，分离并标记彩色负片。用彩色图像分析系统在扫描仪采集图像信息后计算并分析应力面积和平均压力。
随着膝关节屈曲角度增加，应力面积逐渐减小，平均压力逐渐增大。4组不同屈曲角度间应力面积和平均压力差异有统计学意义（P<0.05）。C组应力面积显著低于其他3组，平均压力显著高于其他3组（P<0.05），但A、B、D组间差异无统计学意义（P>0.05）。
膝关节半月板损伤或切除后，胫股关节面应力显著增加，平均压力显著升高。半月板移植后胫股关节面应力可恢复至接近正常。因此，损伤的半月板在静止状态下也应予以保留或修复。
